-Incrases sebaceous gland activity and sebum production which produces acne

-Incrases erythropoietin in the kidneys

-Decreases HDL cholesterol

-Mild mineralcorticoid properties

ESTROGENS- 2 TYPES-

1. Natural-

-Estradiol

-Conjugated estrogens (OBTAINED FROM THE URINE OF A PREGNANT MARE (HORSE)

2. Synthetic

-Ethinyl estradiol

-Mestranol

PHARMACOKINETICS OF ESTROGEN-

-Well absorbed from GI tract

-Natural estrogens rapidly metabolized in the liver

-Synthetic estrogens are degraded (metabolized) less rapidly

-Most estrogens are readily absorbed from skin and MM, and vaginally

-Enterohepatic cycling- (ESTROGEN GOES TO LIVER AND IS BROKEN DOWN THEN GOES TO GI AND BACTERIA REACTIVATES ESTROGEN MOLECULES AND THEY ARE REASBSORBED BACK INTO THE SYSTEM)accounts for drug interactions, broad-spectrum antibiotic use alters bowel flora and rend OC ineffective.

-Depends on the sexual maturity of the recipient

-Before puberty- Stimulate development of 2ndary sex characteristics

-Adult female- given cycliacally induce artificial menstrual cycle

-Used for contraception

-MUST BE GIVEN WITH PROGESTERONE DUE TO ENDOMETRIAL HYPERPLASIA

-At or after menopause- prevent s/s of menopause, MUST BE GIVEN WITH PROGESTERONE DUE TO ENDOMETRIAL HYPERPLASIA if patient has an intact uterus.

-Protects against Osteoporosis- but shouldn't be prescribed for this alone use Fosamax.

-THE ONLY TIME ESTROGEN CAN BE GIVEN ALONE IS IF PATIENT HAS NO UTERUS!!!

-Indications- 21 cycle day pilss, start day 5 of menstural cycle or "Sunday start", acne, dysmenorrhea (is a result of increase in uterine prostaglandins which cause ischemia from small arteries in uterus at time of menstration.

-NSAIDS- prohibit prostaglandin synthesis

ADVERSE EFFECTS OF ORAL CONTRACEPTIVES-

-risk of stroke

-MI, DVT

-thromoembolic complicaitons

-smokeer over age 35- do not give!

-caution- in GB disease, thromboembolic disease, and h/o MI or CAD

-contraindicated in active liver disease (where they are metabolized), breast cancer, or CA of reproductive tract

-increased r/f ovarian and endometrial ca

-increased r/f breast ca

S/E OF ORAL CONTRACEPTIVES-

-acne better or worse

-hisuitism

-increased libido

-oily skin

-DVT

-nausea

-Mastalgia- painful breasts

-migraines better or worse

-no menses- amenorrhea

-weight gain

POSTCOITAL CONTACEPTION RX-

-"The morning after pill- plan B"

-estrogen and progesterone

-not taking other contraceptives!

-taken 72 hours within intercourse

-followed by two doses 12 hours later

-inhibit transport of ova in fallopian tubes and later endometrium to prevent implantation of fertilized ovum

-adverse effects- N/V, h/a, dizziness, leg cramps, abdominal cramps

-comes with a pre-packaged uterine pregnancy test.

ORAL CONTRACEPTIVE DANGEROUS S/E'S-

ACHES

A- abdominal pain (GB disease)

C- chest pain (MI)

H- headache

E- eye problems

S- severe leg pain (DVT)

STOP TAKING IF ANY OCCUR!!!!

ESTROGEN INTERACTIONS-

-drugs which increase heaptic metabolism of OC

-increases possiblitly of contraceptive failure- metabolized out of the system